Time For Trauma Funding

James Shepherd

Billy Hodges, a Sumter County farmer, had never heard of the “Golden Hour” of medical care following a traumatic injury. And he’s not alone. If asked, Billy would have told you what many in south Georgia assume: My local hospital can treat any traumatic injuries I might sustain.

I like to tell Billy’s story because those of us at Shepherd Center, a spinal cord and brain injury rehabilitation hospital in Atlanta, are passionate about the point it makes. Every Georgian needs to live within 60 minutes of a certified trauma center. Billy did not. Of course, his story is extraordinary because he beat the odds and is doing well.

But even a cursory examination of his experience makes the case that Georgia’s General Assembly needs to fund an expanded trauma system to include more trauma centers, particularly in south Georgia. Only 15 of the state’s 152 hospitals maintain the medical staff and equipment needed to treat severe injuries and be certified as trauma centers. Only two of those are south of the “gnat line” – one in Savannah, the other in Thomasville.

Billy was flying a small plane that crashed in August 2007 in rural southwest Georgia, just outside the Golden Hour. It took about 90 minutes for rescue workers to get him to Flint River Community Hospital in Montezuma.

Flint River is a fine hospital, but it isn’t a trauma center. Medical personnel there stabilized him for transfer by air to the Medical Center of Central Georgia, a Level 1 trauma care center in Macon. Once there, Billy received expert trauma care that probably saved his life. But he nearly died several times during and after the four-hour trip.

About a month later, Billy was admitted to Shepherd Center and began rehabilitation for brain and spinal cord injuries. Within months, we helped him get back on his feet. Today, Billy is back at work and driving. He hasn’t started flying again, but he hopes to soon.

For every Billy Hodges, there are dozens who either don’t survive or face protracted and expensive recoveries because their trauma occurred more than a Golden Hour from a trauma center. Every year at Shepherd Center, we admit more than 700 people who have sustained spinal cord and/or brain injuries – far too many of whom, like Billy, had to wait for trauma center treatment.

Improving Georgia’s trauma system won’t be cheap. It will take an estimated $85 million a year to stabilize our existing, substandard trauma system and $275 million to build an ideal system. Even at the high end, that works out to less than 8 cents per Georgian per day – or about $29 a year.

For that price, we cannot afford to allow this crisis to continue. Beyond the human toll, the social and economic costs of our inadequate trauma system are massive. They include potential increased costs incurred by a delay in treatment. For example, when someone sustains a spinal cord injury (SCI), the nationally accepted protocol of treatment is a timely surgical decompression procedure – which must be done by a neurosurgeon – and steroid therapy. Getting this treatment at a designated trauma center within a few hours after injury may mean the difference between an incomplete SCI and a more costly and disabling complete SCI.

The estimated lifetime costs are about three times higher for someone with a complete, high-level SCI versus a person with an incomplete SCI. That’s a difference of an estimated $2 million in lifetime costs per person with SCI that we, as taxpayers, may have to subsidize through Medicaid or Medicare – and that’s without factoring in lost productivity and earning power of the individual.

We think this kind of trauma care is a must. It makes economic sense, it makes community development sense, and most important, it saves lives and improves the quality of lives. We know that without it, not everyone will be as fortunate as Billy Hodges.

Editor’s note: The Shepherd Center is not a trauma center and would not benefit from increased trauma funding by the state. For more information about trauma care in Georgia, go to www.georgiaitsabouttime.com.